| NPI | 1861658718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A120391) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA 60208875) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2021-11-30 |